War-like injuries use up skin-graft stocks

By Ruth Pollard, Health WriterOctober 16 2002

The "war-like" injuries suffered in the Bali bombings have exhausted Australia's supply of bio-engineered skin used to treat badly burned patients.

Peter Haertsch, the director of Concord Hospital's burn injury unit, said two "horribly injured young people" had arrived yesterday. One of them, a young woman from Victoria, had burns to 80 per cent of her body.

"When the first two arrived ... it was evident we were dealing with burn injuries the likes of which we have never seen here before," Dr Haertsch said. "They were the sort of thing you would only see in a war-like situation."

The second patient, a Brisbane man, was operated on yesterday and a third patient with less serious injuries was also treated.

A hospital spokesman said six more people were admitted after arriving on a RAAF Hercules in Sydney last night. Their condition was unknown.

It was obvious the two seriously injured patients had not received medical treatment in "the golden hour" - the first hour after injury, Dr Haertsch said.

During this time "there is a tremendous outpouring of body fluid ... unless they received treatment in that hour the kidneys start to shut down and they go into renal failure", he said.

The two young patients at Concord had experienced blast injuries and "horrible, penetrating wounds" from wood, shrapnel and tin. These wounds were contaminated, and their thermo-regulatory system had shut down.

"I've not seen this combination of injuries - it's something you wouldn't see in civilian life and something I haven't seen in 22 years of burns surgery," Dr Haertsch said.

The Concord team hopes to complete most of the burns surgery by Friday, although for some patients this will go on for weeks.

"Because of the extent of the injuries with at least one of the patients, we will not be able to graft with their own skin," Dr Haertsch said.

Instead, the team will use a revolutionary form of bio-engineered skin, made from neo-natal foreskins, which provides coverage of the wound after the burned skin has been excised.

"We have ordered a significant number of sets - I am told we have exhausted the Australian supply, some of which has also gone to Perth and Adelaide."

They will also use available unburned skin for grafting, and will grow patients' skin in a lab. Dr Haertsch rated the patients' chances of survival as "hopeful".

Of the six people admitted to St George Hospital in Sydney on Monday, a 23-year-old woman from Victoria with serious burns and shrapnel injuries was released yesterday and flown to Melbourne for treatment.

Those remaining in hospital are: a 15-year-old female from NSW; a 23-year male from Queensland; a 22-year-old male, an 18-year-old female and a 23-year-old male from Victoria. A hospital spokeswoman said all were in a satisfactory condition.

A 32-year-old woman from Sydney's southern suburbs is still in Royal North Shore Hospital in a serious but stable condition.

In total, 86 injured people had been airlifted from Bali by last night. Only seven remained in Darwin, with the rest sent on to other capital city hospitals.